This is a blog by a former CEO of a large Boston hospital to share thoughts about negotiation theory and practice, leadership training and mentoring, and teaching.

Monday, September 13, 2010

Dartmouth 1 - Harvard 0

No, that's not the score of the arch-rivals' soccer game. It is a reflection of the vision of Dr. Jim Yong Kim, President of Dartmouth, as embodied in the creation of a new degree program focused on process improvement in the heath care delivery system. An excerpt from Karen Weintraub's story:

6 comments:

Keith
said...

Business guys only react to the almighty dollar. That is their measure and guiding goal. That is why administration often clashes with the clinical side.

Until the incentives are changed, the drive to lower costs (except where they can increase profit)and improve quality will not be embraced. This is what the Obama health care plan attempts to do, but we will see how the intent of the law gets twisted as the details of implementation get put in place.

Leading quality improvement institutions have emerged across the country and internationally for a decade, but HMS seems oblivious to such game-changing rules. We pat ourselves on the back a lot, but we don't look much over our shoulders, do we?

It is interesting to note that except for "medical educators", the degree program does not seem to be aimed at M.D.'s, who are critical participants in, or potential obstacles to, this endeavor. And it is fine to 're-educate' people in mid-career, but it is really the medical students who need training in this area, as noted in the recent Lucian Leape Institute report on medical education.

One of the problems noted in the Leape report is the lack of physician faculty educated in these principles, so perhaps this degree program is at least a first step toward providing them.

I believe both Dartmouth and Harvard-- in fact all who are part of the discussion need to talk beyond the delivery of medical care. Certainly a lot of money is spent and it is important, however, we need to define the context of health care delivery. What are the pre-conditions in society, in community, and by individuals in which medical care will work? To only approach the health delivery components dismisses where people learn most of what they know about health, do most of what makes them sick or well, and can support (or not) the actions of medical system. To be responsible planners -- you/we need to speak for the entire system. The whole system needs to be defined and envisioned. For example, what is in the community? What are the parts of the system that promote health, that educate, the structures or organizations that maintain health and assure people are assimilated in their communities. Less that that is simply about medicine and not about health.

As a future graduate student with a lean healthcare background, this degree is intriguing. But my question to all of the healthcare leaders out there is what kind of job does this qualify someone for? Where would an individual with this degree fit you your organization?